James W. Winkelman

Viral and bacterial organisms associated with acute pharyngitis in a school-aged population

To investigate the causes and clinical characteristics of acute pharyngitis among school-aged children (4 to 18 years), we obtained throat cultures for respiratory viruses, Mycoplasma pneumoniae, group A streptococcus, and Chlamydia trachomatis from 320 patients with sore throat and 308 controls without respiratory complaints. The study was conducted from January to April 1985 in a private pediatric practice in central New York State. Sixty percent of the patients and 26% of the control subjects had positive cultures for at least one organism. Forty percent of patients had positive cultures for group A streptococcus, compared with 11.9% of the controls. Fifty (16%) patients had positive viral cultures, compared with eight (2.6%) controls; the predominant viral isolate was influenza A Philippines. Patients infected with influenza A were significantly more likely to complain of cough and hoarseness, and were less likely to have pharyngeal exudate or tender cervical adenopathy, than were patients who had positive cultures for group A streptococcus. Although 49 (15.8%) patients with acute pharyngitis had cultures positive for M. pneumoniae, 53 (17.6%) asymptomatic controls were also had M. pneumoniae-positive cultures. Thus detection of M. pneumoniae in the throat of school-aged children with pharyngitis may not be sufficient to establish a diagnosis of disease caused by this organism. C. trachomatis was not isolated from any patient or control.

NEUROTOXICITY OF TETRAPHENYLPORPHINESULFONATE TPPS4 and ITS RELATION TO PHOTODYNAMIC THERAPY

Abstract Tetraphenylporphinesulfonate (TPPS4) is a synthetic porphyrin that localizes in certain tumors to a higher absolute concentration and with more favorable tumor to other tissue ratios than any other porphyrin yet studied. Its utilization for photodynamic therapy and other applications has been inhibited by reported neurotoxicity. We injected TPPS4 over a broad dose range of 5‐150 mg kg−1 and observed the effects on peripheral nerve in groups of animals sacrificed 35, 70 and 140 days later. No immediate deaths or phototoxic manifestations were seen. Light and electron microscopy, however, revealed cytoskeletal abnormalities and nerve fiber degeneration affecting both myelinated and unmyelinated fibers in all the time and dose groups. These findings have similarities to those of other experimental toxic neuropathies, and may also be related to the preponderance of autonomic manifestations in patients with porphyric neuropathy. The morphological changes consisted of tangles of fibrillar material in the myelinated fibers and loss of neurotubules in the unmyelinated fibers. Our studies indicate a direct interaction of TPPS4 with tubulin. This biological mechanism may be involved in the selective distribution of certain parenterally administered porphyrins.

Quantatiye Studies of Tetraphenytlporphinesulfonate and Hematoporphyrin Derivative Distribution in Animal Tumor Systems

This review will accumulate and compare the very few reports in the literature which quantify the concentration of tetraphenylporphinesulfonate (TPPS) and hematoporphyrin derivative (HPD) in tumors and other tissues after parenteral administration to tumor bearing animals.